Pseudo-renal failure due to intraperitoneal bladder rupture and silent subdural hematoma following a fall in an alcoholic

Abstract

A middle-aged farmer, presented with progressive abdominal pain and distension, an episode of gross hematuria, oligo-anuria following a fall in an alcoholic intoxicated state. He was found to have renal failure, and gross ascites, which rapidly subsided following continuous bladder catheter drainage. Cystogram revealed a tear in the bladder dome, which was repaired. Subsequently, he manifested behavioral abnormalities and evaluation revealed right fronto-temporo-parietal subdural hematoma, which was evacuated through a burr hole. Patient made full recovery and was discharged. Intraperitoneal bladder rupture resulting in acute pseudo-renal failure is a rare entity. Sudden onset abdominal discomfort, increasing ascites, hematuria and oliguria with elevated renal parameters following trauma in an alcoholic needs consideration and exclusion of this entity. Thus, this case report highlights the importance of intraperitoneal rupture of bladder as a cause of pseudo-renal failure. Timely recognition of this entity results in easy management and avoidance of inadvertent dialysis.